How to return to the office with Covid 19

For many of us, COVID 19 has changed the way we practice therapy. It seems like over night we were told to shelter in place and that we could not see our patients face to face. Many of us were not prepared for telehealth and had to make many adjustments on the fly. For now, many states have decided to lift the shelter in place orders and we have another decision. When and how to return to offering face to face or in person services. 

For the states that have lifted stay at home orders, we now face a new challenge. Making the decision of when to return to the office and resume in person service is not an easy one to make. How do you know when the time is right to see patients face to face? When you return to the office?  What safeguards do you need to have in place? How do you talk to your patients about returning to face to face services?

There seems to be a lot of information out there about small business, restaurants, and limitations on large gatherings. But what about the therapy office? It can be hard to sift through it all and figure out what is the best approach for therapists. 

I did some research and after attending a webinar with my malpractice insurance, The Trust, and National Register of Health Service Providers in Psychology, I was able to piece together some guidance as to how to approach this subject.

One message that was clearly stated by the professional boards was just because you can go back to the office does not mean that you should. Using your own clinical judgement as to what is best for not only your health but also the health of your patients is always top priority. Let’s face it, as the provider, your patients will be looking to you for expert guidance. 

As long as you have taken thoughtful and reasonable steps for both your safety and the safety of others, you can be the one who decides when to go back to the office. Since most of the states appear to be opening up in phases, check state and local guidelines to determine if you are permitted to see patients in your office at your location.

It is also important to consider that, although insurance reimbursement for teletherapy services may have been mandated during the COVID-19 pandemic, such mandates may no longer be in effect, and teletherapy may no longer be reimbursed by your insurance company. 

When you’re ready to return to your office, consult the CDC website for their most up to date guidelines.

Here is what the American Psychological Association (APA) recommends:

• Arrange office seating in the waiting room and in therapy/testing rooms to encourage physical distancing. Consider removing the chairs in the waiting room, positioning them far apart or placing “do not sit here” signs.

• If feasible, open windows or take other steps to increase ventilation.

• Wear a mask and ask your patients to do the same. You should keep some in the office for those who may not have one.

• Schedule appointments at intervals to minimize having too many people in the waiting room.

• Ask patients to come into the office five minutes before their appointment time, not earlier.

• Keep hand sanitizers that contain at least 60% alcohol in the office, the waiting room and check-in counter.

• Post notices encouraging people to wash their hands and to avoid touching their face.

• Tell patients and office staff to stay home if they have a fever, shortness of breath or a cough, or have been exposed to someone who shows signs of COVID-19.

• Avoid hugging or handshaking.

• If you use a credit card station, sanitize it after each use. If staff runs the credit cards, they should wear gloves.

It’s important to communicate this information to your current, as well as, potential patients. Publish your office policies about COVID 19 and efforts to keep patients safe on your website and in the office.

You will want to have informed consent documentation for you patients. This is in addition to your regular informed consent for treatment, insurance, HIPAA, etc.

I have put together an example of a consent document to get you started. Please be advised that I am not an attorney, nor do I give legal advice. Also, please revise this to fit the needs of your practice.

Your Logo at the top

Date

Consent For Face to Face (or in person) Psychotherapy Services

Consistent with state and local guidelines for the COVID 19 pandemic, (your name or your practice name) will resume face to face services on (date). If the pandemic or other health and safety concerns resurface, I may resume telehealth services only.

If you prefer telehealth services, I will continue to offer these services. However, please be advised that your health insurance may not reimburse for telehealth services. In such cases, you would be responsible for payment of services.

For health and safety, we will be using the following precautions:

• Maintain social distance of 6 feet or more in office

• Wear a mask while on the premises

• Avoid touching your face or your eyes with your hands

• Wash your hands or use alcohol based hand sanitizer before entering the office

• Do not arrive early to your appointment

• There will be no physical contact with others at the office

• If you have a fever or any symptoms of illness, please notify me 

 We remain committed to following state and federal guidelines regarding this health crisis. We are adhering to prevailing professional healthcare standards to limit the transmission of COVID 19 in our offices.  Despite our careful attention to sanitization, social distancing, and other protocols, there is still a chance that you will be exposed to COVID 19 in our office. If, at any point, you prefer to stop in-person services or to consider transitioning to remote services, please let me know.

By signing below, you acknowledge that you understand that there is still a potential risk of exposure and that you agree to follow the safety protocols outlined above in order to engage in in person services.

As a Psychologist with an insurance-based private practice, I have seen first hand how important it is to have a consistent stream of new clients. And establishing these solid relationships with referral partners has allowed me to have a thriving, six figure insurance-based private practice. For more tips on how to create your dream practice, join my facebook group

Wealthy Therapists Take Insurance.

If you have questions or need help creating your own practice, contact me at Robin@DrRobinMyers.com. I offer Coaching and Consulting Services.